474 LOT NO. 9
NO. SMEET '
APPLICATION FOR APPLIANCE PERMIT
An, F CUPERTINO
Date l< 11 1961 Ll..._ Permit No. /
Fee S
Apgli tin lTbre�r fflt , of Cupertino for a permit to install
gas appli 4�u I tied o re r`e-ver1se�'s°Pi ee hereof, and agrees to install slid
appliances in accordance with the provisions of the Plumbing rude of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
Owne �i/h't-�vt-d '�� _ Address _
I/ H i� ;r,i�l� _ _
CCvvvv y Address
v HEAM!G co rrancro�y tceNr�,
�~ Mike'- PINNATAU AV r r, 26FLI CALIF. Approve
PLUMBING INSPa O
to C)
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